IPACHTE# ~I-L-6 Harnett County Department of Public Health
Improvement Permit 2 6 3 8 9
A building permit cannot be issued with only an Improvement Permit
PROPERTY LOCATION: floe Q~
ISSUED TO: N V-4- co d nt SUBDIVISION ~~£c 4~~ 06C. LOT # 1-
NEW-K REPAIR ❑ EX SION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: 'S(,y- ~,-S'1
R~vc.-5tot~'Strc~
Proposed Wastewater System Type:
Projected Daily Flow: Ll--~`b 0 GPD
Number of bedrooms:
Basement ❑Yes `,IZ No
Pump Required: ❑Yes ❑ No
Type of Water Supply: ❑ Community
Permit conditions:
Number of Occupants: max
,May be required based on final location and elevations of facilities
Public ❑ Well Distance from well LOCH feet
Permit valid for.
XFive years
❑ No expiration
Authorized State Agent:: k5 Date: 7-- \ \ SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuance her permits. The permit holder is resp nsible for checking with appropriate governing bodies in meeting their requirements. This
site is subject to revocation if the site plan, plat, or the intended use changes. The Improvement Permit shall not be affected by a change in ownership of the site. This permit is subject to compliance with the provisions of
the Laws and Rules for Sewage Treatment and Disposal and to conditions of this permit..
Construction Authorization
(Required for Building Permit)
The construction and installation requirements of Rules .1950, .1952, .1954, .1955, .1956, .1951, .1958. and .1959 are incorporated by references into this permit and shall be met. Systems shall be installed in accordance
with the attached system layout.
ISSUED TO: "Y4 Ynfr Cr° O-ue!~ iat1 PROPERTY LOCATION: fldc-s Q,0
SUBDIVISION 1 raoTi -s,2~ (Z--\c~G LOT # \lL1
Facility Type: °J4:D Czl°~-x~, '5Z \ New ❑ Expansion ❑ Repair
Basement? ❑ Yes `--q No Basement Fixtures? ❑ Yes ),No
Type of Wastewater System" asalo R~(~-7 ~ otJ SysiE,,, (Initial) Wastewater Flow: I'l Y(7) GPD
(See note below, if applicable)
2S"/o ~c.G-ctn S y~r5'firN (Repair)
Installation Requirements/Conditions Number of trenches 1
Septic Tank Size Low gallons
Pump Tank Size gallons
Pump Requirements: ft. TDH vs.
Conditions:
Exact length of each trench '1 U
Trenches shall be installed on contour at a
Maximum Trench Depth of. s`~ SKS«H
(Trench bottoms shall be level to +/-1/4"
in all directions)
GPM
inches below pipe
Aggregate Depth: inches above pipe
inches total
WATER LINES (IN(LUDING IRRIGATION) MUST BE ]OFT. FROM ANY PART OF SEPTIC SYSTEM OR REPAIR AREA.
NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA.
**If applicable: /understand the system type speciTed is different from the type specifed on the application. / accept the specifIcatim of this permit.
Owner/Legal Representative Signature: Date:
This Construction Authorization is subject to revocation if the site plan, plat, or the intended use changes. The Construction Authorization shall not be transferred when there is a change in ownership of the site. This
Construction Authorization is subject to compliance ' e provisions the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Futhoed State Agent: N5 Date: S ~G
Cons ction Authorization Expiration Date: lc~
feet Trench Spacing: Feet on Center
Soil Cover: C inches
inches (Maximum soil cover shall not exceed
36" above the trench bottom)
HTE # Permit # aC3'~ ~
Harnett County Department of 1---'tiblic Health
Site Sketch
PROPERTY LOCATON: 00C-5 `0
ISSUED TO: `In+~ CONS c-C SUBDIVISION 6zo'CST~LS LOT #
Authorized State Agent: o~Date: 1C V~
-3",_0 Lt -
N~AQ 6~1-1G25 s
R.
136
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Department of Environment, Health and Natural Resources Shea:
Division of Environmental Health Property ID:
On-Site Wastewater Section Lot
SOIIJSIT$ EVALUATION File !l:
Code:
for ON-SITE WASTEWATER SYSTEX
Owner: Applicant:
Address: Data Evaluated:
Proposed Facility: '7. Design Flow (.1949): tin; or e' Property Size:
Lomtioa of Sits Froperty Recorded:
Water Supply; Public ❑ Individual ❑ Well ❑ Spring
Evaluation Method: [ Auger Boring ❑ Pit Cut
Type of Wastewater. Sewage ❑ Industrial Process C3 Mixed
P
R
O
F SOIL MORPHOLOGY sit
1 .1940 .1941 PROF118 FACit
L I a wlespe Horizon .1941 -
posiflow 943
E Depth .1941 .1941 soil 7-
Slope % (1e.) stuclurd Conddame wetnud oil
1~=7 C
1 tC?' Sam SC SG-~t-F~ 4> qq
❑ Other
.1936
L
Other Factors ( 19M)
Site CluMcation (.1948k
Evaluated By:
Others Present:
F
to aQ 3 t}Y Y
,t \
.1944 Froitt®
ReAr Clan
Boris. d1 LTAX
'S-
5